Investigation of the Excretion of Triamcinolone Acetonide and Its Metabolite

Abstract

Triamcinolone acetonide (TA) is a synthetic corticosteroid commonly used in medical practice to treat various skin conditions, including eczema, dermatitis, and allergies. It is a highly potent derivative of triamcinolone, with a strength that is about eight times greater than prednisone. Although it is sometimes used by athletes, it is important to note that the World Anti-Doping Agency (WADA) prohibits the use of glucocorticoids in competition when administered via injection, oral (including oromucosal, such as buccal, gingival, or sublingual), or rectal routes. However, they are allowed if administered otherwise, such as via inhalation or topical application to the skin. Anti-doping laboratories generally report Adverse Analytical Findings (AAF) for glucocorticoid group substances when their estimated concentration exceeds 30 ng/mL, with some exceptions such as triamcinolone acetonide, which has a reporting limit of 15 ng/mL. It is important to note that this only applies to the parent compound of specified metabolites. To address interpretation issues that can arise with other glucocorticoids, such as budesonide, the authors of this study investigated whether similar issues occur with triamcinolone acetonide. Specifically, they examined whether therapeutic doses of the commonly used medication Previsone could result in anti-doping rule violations due to the presence of triamcinolone acetonide and its metabolites in urine. The study involved ten healthy volunteers, and the analytical procedure was developed using liquid/liquid extraction, hydrolysis, and LC/MS/MS analysis. The results of the study showed that topical administration of therapeutic doses of Previsone does not pose a threat of anti-doping rules violation, as the excretion of the parent compound does not exceed the reporting limit in urine. Additionally, the concentration of 6β-hydroxy Triamcinolone acetonide was also well below the reporting limit.